Table 2.

Time-Adjusted Reversal of Warfarin^*

Time until Procedure	Intervention for Reversal
Greater than 5 days	Hold warfarin 5 days before procedure
5 days to 24 hours	Hold warfarin and check INR 24 hours preprocedure
24 hours	Hold warfarin, check INR
	• For INR 1.5–1.9 give 1 mg vitamin K orally
	• For INR >1.9 give 2 mg vitamin K orally
Less than 24 hours or emergent	Hold warfarin, check INR
	• For INR 1.5–3 give 2 units fresh frozen plasma and recheck INR
	• For INR >3 give fresh frozen plasma and consider factor concentrates

INR, International normalized ratio.

^*Ideally, reversal of warfarin is planned prior to the procedure. If recognized long in advance of the procedure, warfarin may simply be withheld. However, if the procedure is emergent, reversal with fresh frozen plasma or factor concentrates may be required to safely reverse warfarin.